Multiple giant placental chorioangioma: A case report

Key Clinical MessageGiant chorioangiomas, despite being rare, pose significant fetal and maternal risks. Timely and individualized treatment plans are crucial to reduce morbidity and mortality when fetal compromise occurs. Additionally, successful conservative management relies on consistent ultrasound monitoring, Doppler flowmetry assessments, and amniotic fluid level measurements.AbstractChorioangiomas are benign placental tumors that manifest in approximately 1% of pregnancies. Giant chorioangiomas, characterized by tumors exceeding 4 cm, are exceptionally rare and pose substantial risks to maternal and fetal health. This case report details a patient with multiple giant chorioangiomas, emphasizing the rarity and consequential complications associated with these tumors. A 23-year-old woman, G3P2, at 28 weeks gestational age, was diagnosed with multiple large, well-defined placental masses with increased vascularity, indicative of giant placental chorioangiomas. Subsequent ultrasound revealed various fetal anomalies such as cleft palate and lip, as well as lung and heart abnormalities. At 34+5 weeks of gestation, an emergency cesarean section was performed due to preeclampsia. Subsequently, a female neonate was born with hydrops fetalis. Unfortunately, she passed away within the first hour of her life. Complications associated with chorioangiomas primarily arise from arteriovenous shunts, which potentially lead to compromised fetal perfusion and cardiac failure. Although small-sized chorioangiomas are often discovered incidentally, Doppler ultrasound and magnetic resonance imaging can reliably distinguish these tumors from other placental lesions. Additionally, management strategies tailored to gestational age and maternal-fetal symptoms typically necessitate a multidisciplinary approach. However, additional research is essential to understand the mechanisms of chorioangiomas and to develop comprehensive management guidelines. (A-C) The Doppler ultrasound of placental chorioangiomas showing the feeding vessels. (D) The MCA-PSV measurement at 31 weeks of gestation corresponded to 2.14 multiples of the median (MoM).image